Precise Imaging Expands with a New Radiology Center in Fresno, CA

The new center on West Shaw Lane features an Open MRI and X-Ray services, providing the community with enhanced diagnostic capabilities.

FRESNO, CA – Precise Imaging, a leading provider of diagnostic imaging services, is thrilled to announce the opening of its new radiology imaging center located at 2540 W. Shaw Lane, Suite 112-A, Fresno, CA 93711. The latest addition to the Precise Imaging network is now ready to serve the Fresno community and the surrounding areas, offering an Open MRI and X-Ray services.

With a continuous commitment to providing high-quality, accessible imaging services, Precise Imaging has invested in cutting-edge technology at its new Fresno center to ensure accurate and timely diagnoses. The Open MRI service aims to deliver a comfortable and less claustrophobic experience for patients, while the advanced X-Ray services ensure precise imaging for a variety of medical needs.

The Fresno location not only expands Precise Imaging’s geographical footprint but also reinforces its mission to offer patient-centric, technologically advanced imaging services to a broader spectrum of patients. This expansion underscores Precise Imaging's dedication to community healthcare and its endeavor to be at the forefront of diagnostic imaging services.

"We are elated to extend our services to the Fresno community," said Mike Rashidi, VP of Precise Imaging. "Our new center is equipped with an Open MRI and XRAY services to ensure precise and quick results. With a team of experienced radiologists and technologists, we are here to provide compassionate care and superior imaging services to all our patients."

The center is open M-F 8am-7pm and adheres to rigorous safety and sanitation protocols to ensure a safe environment for both patients and staff.

For more information about Precise Imaging and the new Fresno radiology imaging center, or to schedule an appointment, individuals can or call 800-558-2223

About Precise Imaging:

Precise Imaging offers a comprehensive range of diagnostic imaging services with a network of easily accessible imaging centers. With a focus on providing high-quality imaging and outstanding patient care, Precise Imaging is dedicated to meeting the diverse needs of patients, medical professionals, and healthcare organizations.

The Power of MRI Exams in Personal Injury Lawsuits

The health and wellbeing of individuals are often vulnerable to mishaps and accidents that can cause personal injuries. Such injuries could result in a legal dispute where the injured person, known as the plaintiff, seeks compensation for damages from the person or entity they believe caused their injury. In these instances, a comprehensive understanding of the injury's extent is paramount, often heavily relying on medical records and procedures. One such crucial diagnostic tool is the Magnetic Resonance Imaging (MRI) examination. This article delves into how MRI exams can provide substantial assistance in personal injury lawsuits.

MRI is a non-invasive imaging technique that employs a powerful magnetic field and radio waves to generate detailed images of the inside of a body, typically focusing on soft tissues and organs. Unlike other imaging techniques like X-ray and CT scans, which primarily concentrate on skeletal injuries, MRI scans provide a comprehensive view of non-bony structures, like muscles, ligaments, tendons, and even the brain. This ability to visualize soft tissues makes MRI a valuable tool in evaluating the full extent of an injury.

In the context of personal injury lawsuits, MRI scans serve multiple critical roles. Primarily, it provides an objective basis for the plaintiff's claims of injury. Subjective symptoms like pain, discomfort, or restricted mobility may not convince a jury. However, visual evidence of damage, such as a torn ligament or herniated disc, becomes a tangible piece of evidence supporting the plaintiff's claims. By demonstrating the injury's existence and severity, MRI results can counter any argument that the plaintiff is exaggerating or feigning their condition.

Secondly, MRI results can contribute to determining the prognosis of an injury. The extent of damage revealed in the scan can help predict the duration of recovery, potential complications, and the possibility of permanent disability. This information is crucial in estimating the future medical costs, loss of earnings, and even non-economic damages like pain and suffering, which the plaintiff may include in their claim for compensation.

Furthermore, the timing of an MRI can also be a strategic element in a personal injury case. Early MRI exams might not reveal certain types of injuries like soft tissue damage, as these can take time to manifest. An MRI performed too soon could lead to an underestimation of the injury's extent, possibly harming the plaintiff's case. On the other hand, an MRI conducted too late might give the defendant an opportunity to argue that the injury was caused by something other than the initial incident. Hence, the timing of MRI is a critical factor in personal injury cases.

Finally, it's important to note that MRI results need to be interpreted and presented by a medical expert. Precise Imaging has several board certified radiologist that will review the images taken by the technologist and provide a report with their finding.

In conclusion, MRI examinations can be a powerful tool in personal injury lawsuits, aiding in confirming the existence and severity of an injury, predicting its prognosis, justifying medical expenses, and providing compelling evidence for the jury. However, these benefits are maximized when the timing of the MRI and interpretation of its results are strategically managed. It's crucial for individuals in these situations to consult with both medical and legal professionals to ensure the most effective use of MRI examinations in their case.

Diagnostic Imaging and Pre-Existing Conditions in Car Accident Claims

Diagnostic imaging is a powerful tool for car accident claims — but that’s true for insurance companies as well as plaintiffs. Personal injury attorneys often seek MRI scans and X-rays to demonstrate undeniable proof of injury. On the other hand, insurance companies will pounce on any hint of a pre-existing condition to avoid hefty payouts.

Don’t let insurers confuse the jury on the subject. In most states, a long-standing legal doctrine upholds the plaintiff’s right to damages in car accident cases. Pre-existing conditions are rarely the lone cause of injury for victims of car wrecks, and aggravating a condition still counts as injury.

Here’s what you need to know about car accident claims involving evidence of a pre-existing condition uncovered during imaging tests.

Degenerative Disc Disease in a Car Accident Case

Suppose you have a client who has been in a car accident, and is now suffering from lower back pain. An MRI scan reveals lumbar strain, but it also shows clear signs of degenerative disc disease. The insurer is likely to argue that the pre-existing condition reduces their liability for the injury.

This is by no means a rare scenario. Degenerative disc disease is extremely common; in fact, disc degeneration is all but inevitable for people older than 60. But many people who technically meet the diagnostic criteria for the condition don’t experience any symptoms at all.

The question under the law is not whether the pre-existing condition caused the injury; it is to what extent the accident produced the damage. The patient’s susceptibility to injury should not affect the value of the settlement; the court must consider the extent of the injury, not the plaintiff’s fragility.

The Eggshell Doctrine in U.S. Personal Injury Law

The Eggshell Doctrine is well established in most states. The maxim holds that defendants remain responsible for at-fault injuries regardless of the plaintiff’s pre-existing health conditions. In the above example, this would mean that, if the car accident led to a lumbar sprain in the victim, the presence of asymptomatic degenerative disc disease should not invalidate the claim.

In short, there’s no need to worry that an MRI scan, X-ray, or other form of diagnostic imaging will harm the plaintiff’s case. Even if advanced imaging techniques reveal pre-existing conditions, if the victim was injured in a car accident and another driver was at fault, the case remains strong.

Precise Imaging works with personal injury attorneys to obtain restitution for plaintiffs in multiple states. We offer the experience, flexibility, and patient-centered care it takes to win car accident cases, and we offer a suite of resources just for attorneys. Browse our online tools for lawyers here.   

To book an appointment for a client, call Precise Imaging at 800-558-2223 today.

Taxes on Personal Injury Settlements: Tax Cuts and Jobs Act Rewrites the Rules

Taxes on Personal Injury Settlements: Tax Cuts and Jobs Act Rewrites the Rules


On December 22, 2017, the U.S. President signed the Tax Cuts and Jobs Act, more properly known as Public Law No. 115-97. This law makes sweeping changes to tax brackets and multiple changes to once-familiar deductions. As it turns out, though, the new tax code also has major impacts on plaintiffs awarded settlements or damages in personal injury cases.


In short, payments resulting from personal injury cases are not always tax-free. In fact, thanks to the new rules, plaintiffs may end up paying taxes on money that they never receive in the first place. The latest tax overhaul adds to the confusion of an already-complex taxing situation.


Here's what plaintiffs need to know about the tax obligation associated with damages for personal injury cases, including provisions added under the latest tax overhaul:



  • Only compensatory damages are eligible for tax-free treatment. Personal injury damages can be either compensatory or punitive. Only compensatory damages — funds awarded to make up for losses, such as medical payments, property damage, or reduced earning potential — qualify as tax-free. Punitive damages, intended to dissuade the defendant from similar action in the future, are taxed as plaintiff income.   




  • Emotional distress — and physical manifestations of emotional distress — are subject to taxes. Plaintiffs in personal injury cases sometimes receive awards for mental anguish or emotional distress. The IRS taxes these funds as income. Only damages awarded for physical injury or illness may escape taxation.



Of course, developing research attests to the close relationship between the body and the mind. Emotional distress can lead to physical symptoms, many of which mirror those of a physical illness. However, even if mental anguish leads to physical symptoms, and the plaintiff receives damages reflecting the condition, those funds remain taxable as income. The root cause of the illness or injury must be physical for damages to go untaxed.



  • Damages awarded for emotional distress resulting from a physical injury may be tax-free. Here's where the existing tax code gets tricky. Damages reflecting emotional distress that leads to physical illness are taxable income. However, damages reflecting emotional distress arising from physical illness may, in fact, be tax-free.



As attorney Robert W. Wood points out in Tax Notes, this leads to a difficult chicken-and-egg dance between collecting plaintiffs and the IRS. An unthoughtful worded case could lead the IRS to conclude that injuries are primarily emotional, and therefore fully taxable. On the flip side, a cleverly worded argument may place the primary injury in the physical realm, leading to tax-free damages. Note that in either case, the symptoms may be identical — under tax law, the real question is which came first: The physical or the mental injuries?  



  • Under the new tax law, plaintiffs cannot deduct taxable recovery payments including those that go to pay legal fees. This is perhaps the Tax Cuts and Job Act's most striking change to taxation of personal injury damages. Plaintiffs with contingent-fee attorneys, who take payment as a percentage of the damages or settlement, are now responsible for taxes on the full value of the taxable pay-out.



Under previous law, the plaintiff could deduct legal fees taken out of damages. No longer. Say a plaintiff receives $1 million in damages for emotional distress. This is taxable income, according to the IRS. Now, say this plaintiff hired a contingent-fee attorney, who collects 50 percent of the damages. The plaintiff will walk away from the case with $500,000, but will pay taxes on the full $1 million.    



  • Legal fees associated with workplace claims may, in fact, be deductible. In some cases, plaintiffs can escape the tax burden of their legal fees. Claims against an employer may allow the plaintiff to deduct legal fees. If the defendant is not the employer, though, plaintiffs are on the hook for taxes on the full amount of damages or settlements, regardless of what their legal team takes home.



Given the shifting legal ground and the tax complexities associated with personal injury lawsuit damages, plaintiffs should work with tax professionals to ensure they meet all obligations under the law. Tax laws surrounding personal injury cases get terribly complicated.


Consider, for instance, that many cases involve damages with a mixture of taxable and non-taxable awards. For instance, a plaintiff may be awarded half the damages for emotional distress not arising from physical injury, and the other half for the injury itself. That plaintiff would have to pay taxes on the amount awarded as compensation for the emotional injury, but not funds deriving from the physical ailment.


If settlements aren't written very carefully, with exact amounts attributed as compensation for exact conditions, the tax obligation becomes very murky indeed. As in cases of medical care themselves, these issues are best left to the professionals. Taxes on personal injury settlements in the wake of the Tax Cuts and Jobs Act are certainly not for the faint of heart.  


Note: This analysis is not intended as legal advice.


How Digital Access to Medical Images Helps Personal Injury Lawyers

How Digital Access to Medical Images Helps Personal Injury Lawyers


Diagnostic imaging is one of the clearest, most powerful ways to demonstrate objective manifestation of injury in a lawsuit. But like any piece of evidence in trial law, quality matters. Standard-quality images that clearly show a broken bone or inflammation to a trained radiologist might be meaningless to the jury. Medical images in the legal realm must be pristine.  


Luckily, we've come a long way from the days of lightboxes in the courtroom. Precise Imaging offers attorneys 24/7 access to medical images in their cases through a dedicated portal built just for them. These digital files provide a number of advantages that can make it much easier than it used to be to prove objective manifestation. Here are just a few of these benefits:


  • Digital images are easy to display in high-definition in a variety of settings. High-definition digital images look great whether you're working with an iPad on the train or displaying on a large-screen TV in front of the entire courtroom. You can also send them in an instant, rather than relying on physical CDs or film.


  • Cloud access allows attorneys to work when and where they must. Cloud storage keeps reports and images themselves available for working remotely. Lawyers simply log into the Precise Imaging attorneys portal to view their clients' medical imaging results at any time of the day or night. Even the tech support is available 24/7, ensuring the sort of flexibility today's personal injury professionals need.  


  • Collaboration is easier when all parties can remotely view the same images and reports. It isn't always easy to get the whole team together in a room. The cloud makes it possible for attorneys, their clients, and their legal teams collaborate remotely by viewing images together, at the same time, but in different places.


  • Digital files are easy to share with opposing counsel during discovery. The plaintiff's team isn't the only ones who need access to medical images. When it comes time to share this critical data with the opposing counsel, digital access makes things easy. The remote characteristics of cloud storage let everyone appropriate — including opposing counsel — access medical images when they must. Attorney's web portals through Precise Imaging streamline the process.    


The Precise Imaging attorney's portal is just one of the ways we serve attorneys. We also accept letters of protection and liens, whether they're associated with personal injury suits or workers' compensation cases.


Perhaps most importantly, we have the capacity to handle an attorney's entire case load with a single point of contact. Rather than searching through multiple log-ins and customer-service numbers for imaging services, attorneys who work with Precise Imaging can keep all of their case data at hand, with HIPAA-compliant security.


To learn more, or to refer a client, call Precise Imaging at 800-558-2223.  


How Diagnostic Imaging Could One Day Affect Tax Laws for Personal Injury Settlements

How Diagnostic Imaging Could One Day Affect Tax Laws for Personal Injury Settlements


With the 2017 passing of the Tax Cuts and Jobs Act, IRS tax policy on personal injury cases is back in the spotlight. At the same time, for the past few years, the legal profession has been absorbing the impact of ever-more detailed imaging studies that, some argue, display a physical basis for certain neurological phenomena, including disorders like PTSD and subjective experiences like pain itself.


Strangely, these two seemingly unrelated forces — tax laws for personal injury cases and the use of advanced imaging technologies in the courtroom — could combine to affect the take-home damages that plaintiffs receive from a successful lawsuit. Here's how, in a point-by-point analysis:


  • Tax laws for compensatory damages are complex, even circular. According to the IRS, damages paid out for physical injuries are tax-free. Damages for emotional injury, however, are fully taxable.


  • As researchers uncover more about the complex unity of physical and emotional systems in the human experience, courts and the IRS are faced with a challenge. Emotional trauma often leads to physical symptoms. Likewise, bodily injuries often result in emotional side effects. The two are difficult to separate. So which set of compensatory damages can legally go tax-free?  


  • Under current precedent, the IRS holds that taxability is associated with the principal injury. Cascading effects are lumped in with the root complaint. So if a defendant physically injures or sickens the plaintiff, compensatory damages awarded in the case are tax-free, even if some of those damages are paid out for emotional effects associated with the injury. Conversely, if the defendant's negligence leads to emotional harm, and that psychological trauma manifests in physical symptoms, damages are fully taxable, even if some portion is awarded in compensation for bodily sickness arising from emotional distress.  


  • The Tax Cuts and Jobs Act raises the stakes on this issue of taxation. Plaintiffs who hire contingent-fee attorneys are now responsible for paying taxes on 100 percent of case-related payments — including that portion that goes to pay the lawyer. Under previous law, attorneys and plaintiffs each assumed their share of the tax liability associated with taxable payments resulting from the same case.


  • Here's where advanced imaging could change the landscape. In 2008, the Arizona Superior Court in Pima County heard a landmark case, Koch v. Western Emulsions, Inc. The court allowed evidence of chronic neuropathic pain obtained with an fMRI scan, which the plaintiff's expert witness said showed a clear physical pattern of brain activity "proving" the existence of the pain. Ultimately, the defendant settled for $800,000, more than 10 times their initial offering.


  • Since Koch, the scientific community has warned against using advanced imaging as a sort of "painometer." The science just isn't there yet, and there are ethical issues involved in imposing "mind-reading" technologies on plaintiffs, researchers say.


  • But brain scans are showing physical changes associated with a lot more than pain. In one study, MRI scans showed changes in the physical structure of the hippocampus in  Vietnam veterans with PTSD. Some had an 8 percent reduction in volume of the right hippocampus.


The question this all leads us to, then, is where to draw the line between physical and psychological injury. Advanced imaging technologies will continue to show greater levels of detail in the troubled brain. At some point, the courts and the IRS will have to wade into one of the most philosophically murky questions of all time: the mind-body problem. More to the point: Is there any injury, psychological or otherwise, that cannot be described as physical?


The answers we come up with will have dramatic effects on the value of settlements, damages, and tax payments in the years to come.



How the Tax Cuts and Jobs Act Affects Personal Injury Attorneys

How the Tax Cuts and Jobs Act Affects Personal Injury Attorneys


The Tax Cuts and Jobs Act of 2017 made headlines by dropping the corporate tax rate from 35 percent to 21 percent. While that sounds like great news for every business, many personal injury attorneys operate as pass-through entities—not corporations.


So will personal injury firms get a tax break under this new law? The answer is, as so often in matters of tax law, both simple and complex: It depends. Here are a few things that every personal injury lawyer should know about the new tax law:


  • Pass-through businesses can take a new deduction—but only under certain income limits, and odds are attorneys don't make the cut.


Certain pass-through organizations—sole proprietorships, partnerships, and S corporations, for example—can deduct up to 20 percent of business income from their taxes under the new law. But the benefit scales down at a certain income threshold, and many personal injury attorneys may not be able to take advantage.


The deduction cap is reduced at a limit of $175,000 for single filers and $315,000 for married couples. At an annual income of $415,000, the deduction disappears entirely.     



  • Firms that are organized as corporations will benefit from the reduced corporate tax rate.



Of course, not every personal injury firm is organized as a pass-through. Businesses that are taxed as corporations can take advantage of the heavy drop in the corporate rate, which, as we mentioned, dropped from 35 percent to 21 percent.



  • Contingent-fee attorneys in the Ninth Circuit narrowly avoided an end to deduction benefits.



At Precise Imaging, we work with lots of contingent-fee lawyers, thanks to our flexible payment program that includes liens and letters of protection. So we know that deductions for these legal firms operate differently in California and the rest of the Ninth Circuit than they do elsewhere in the nation.


Attorneys who work through gross fee contracts, in which they agree to pay legal costs through their own percentages at the conclusion of a case, are allowed to deduct those costs. An early draft of the Tax Cuts and Jobs Act ended this deduction for the Ninth Circuit, but by the time the President signed the bill into law, that provision was gone. So contingent-fee attorneys with gross fee contracts can continue to deduct costs in California and elsewhere.


This last point brings us to the services we at Precise Imaging provide for personal injury attorneys. Diagnostic imaging can be considered a legal cost, and as such, the expense is often deductible for Ninth-Circuit lawyers with gross fee contracts.


To discuss the ways diagnostic imaging can help with a personal injury case in California and beyond, or to learn more about liens and letters of protection for imaging services, call us at 800-558-2223.  

Diagnostic Imaging for Traumatic Brain Injury (TBI): What Every Attorney Should Know

Traumatic brain injury (TBI) can be one of the most devastating results of an at-fault accident, in a car, on the job, or even just walking down the sidewalk. The sheer volume of human systems that the brain controls — all of them, essentially — leads to an extraordinarily diverse set of symptoms in cases of TBI. Convincing judges and jurors that these disparate symptoms can all be traced back to a preventable injury is not always easy.


The irony here is that a moderate or severe TBI can lead to challenges that most deserve restitution. Some brain injuries are so severe that they deprive the victim of the ability to work. Others might even prevent a patient from participating in the tasks of daily living necessary for independence. If a client in a TBI-related personal-injury case is to be made whole, settlements may have to provide for them for the rest of their lives.


This combination of high stakes and soft proofs makes it imperative that attorneys in such cases understand diagnostic imaging. After all, while a defense team may be able to convince the judge that behavior changes are unrelated to an accident, it is hard to argue with an image of a damaged brain.


Here are a few things that personal injury lawyers should know about diagnostic imaging as it relates to TBI:


  1. Different modalities excel at documenting different types of injuries. Radiologists are likely to use standard diagnostic tests like CT and MRI scans to diagnose TBI. They might order X-ray scans, but only in cases of suspected damage to the skull; X-ray images do not differentiate between soft tissues. Doctors might even prescribe advanced imaging techniques, such as perfusion CT, diffusion tensor imaging (DTI), or magnetoencephalography, a form of fMRI.   



  • CT scans without contrast are the primary modality used to identify most primary, acute injuries. A TBI is not a single injury, but a cluster of related events. Doctors divide TBI into primary and secondary injuries. The first occurs at the moment of impact, causing a chain-reaction of events within the brain that often lead to further damage: secondary injuries. This is why doctors typically prescribe ongoing diagnostic imaging for TBI patients.



While advanced imaging modalities including brain-function tests like PET scans and functional MRI may identify secondary injuries, the first-line test for diagnosing primary TBI is the noncontrast CT scan. This is the fastest way to accurately expose bleeding that requires immediate surgery.   


  1. Doctors use MRI scans to identify certain types of TBIs that do not always show on a CT scan.  While doctors typically order CT scans first, there are some types of TBI that require MRI for identification. When a primary TBI does not result in intracranial bleeding, MRI scans are often the better choice. Injuries that the MRI identifies better than CT scans include brain bruising and traumatic axonal injury (TAI), shear-strain damage to white matter caused by the brain's rapid acceleration within the skull.       


As in any case involving diagnostic images, attorneys should engage expert witnesses such as neurologists or radiologists to explain what's going on in the pictures. This is particularly important in brain-function scans, such as fMRI and PET scans, which are often inscrutable for untrained viewers.  


The good news for attorneys new to TBI cases and the diagnostic interventions that document them is that expert help is available. This brings us to our next point.  

Expert Assistance for Personal Injury Cases Representing Victims of TBI


Personal injury lawyers and their clients deserve the chance to focus entirely on a TBI case. That can't happen when they're navigating complex scheduling systems at large hospitals or arguing with insurance companies. That's why Precise MRI always strives to provide for attorneys and their clients with what they need, when they need it.


Precise MRI offers quick turnarounds on radiology reports, with same-day scans and results within 24 hours. We provide more than 70 imaging centers in California, Arizona, and Nevada for convenient, close-to-home access for patients. Our friendly scheduling staff will find an appointment that works for your client, even on weekends and evenings.


Attorneys themselves have their client's crucial information at their fingertips thanks to an online portal designed for legal professionals. It's available 24/7, and so is IT service, ensuring that patients and their lawyers can access medical data at their own convenience.


We accept personal injury liens — and even offer a free, downloadable lien form for immediate access — and attorney letters of protection for personal injury. Our teams of fully certified medical professionals have long-term experience working with attorneys on all sorts of personal injury cases, including those involving TBI. Even more important, they're devoted to a patient-based model of care, and work hard to ensure quality, comfort, and convenience for all.


To learn more about attorney resources from Precise Imaging, or to schedule a CT or MRI scan for a client, call us today at 800-558-2223.  




Hill CS, Coleman MP, Menon DK. Traumatic Axonal Injury: Mechanisms and Translational Opportunities. Trends in Neurosciences. 2016;39(5):311-324. doi:10.1016/j.tins.2016.03.002.


Kim JJ, Gean AD. Imaging for the Diagnosis and Management of Traumatic Brain Injury. Neurotherapeutics. 2011;8(1):39-53. doi:10.1007/s13311-010-0003-3.

Diagnostic Imaging in Spinal Injuries: A Guide for Personal Injury Lawyers

It's difficult to overstate the importance of diagnostic images in spinal injury litigation. When properly presented, a diagnostic image offers clear, compelling evidence—but if the image doesn't clearly show the injury, or if there's any question as to the validity of the attorney's interpretation, the entire case can be compromised.

Of course, every personal injury attorney understands these points, but in order to use images effectively, they should understand the basics of different imaging technologies. That includes the tactics that radiology professionals must employ to deliver high-quality, diagnostically relevant images.


How Types of Spinal Injuries Affect the Diagnostic Imaging Process


The first consideration is the severity and location of the injury. Magnetic resonance imaging (MRI) provides the best diagnostic images for spinal cord and soft-tissue injuries, both for radiology professionals and for laypersons (while diagnostic images need to be evaluated by a trained professional, the images are obviously more useful to attorneys if the injuries are clearly visible and easy to explain).

MRIs can show chronic issues such as spinal misalignment. Spinal fractures are easier to identify via computed tomography (CT), while spinal vascular injuries can be evaluated with either technology. In any case, trained radiology professionals working with the latest tech can discern a surprising amount of information, including the approximate age of the injury, which can help attorneys build winning cases.


Choosing Diagnostic Imaging Services for Personal Injury Cases

Personal injury attorneys should keep other practical considerations in mind when directing their clients.

As mentioned earlier, timing is often a crucial factor, particularly in spinal fracture cases. An imaging facility should be able to produce high-quality results quickly and at a fair cost — and, for the benefit of the attorney, those images should be in commonly used digital formats, ready for reproduction. Many attorneys choose to highlight certain parts of MRIs and CT scans with software designed for the purpose; without exceptional images, this can be a difficult process.


Finally, as we've mentioned on other blogs, imaging centers should be prepared to handle various types of remuneration and should have experience with workers' compensation and letters of protection.


Precise Imaging offers dedicated tools for attorneys through a specialized HIPAA-compliant web portal, which provides 24/7 access to images, case details, and payment information. We're dedicated to keeping patients comfortable, and with more than 70 facilities, we offer unequaled access to qualified imaging experts and state-of-the-art technology.

To learn more about Precise Imaging’s commitment to assisting in personal injury cases, or to refer a client today, call 800.558.2223. You can also make an online referral here.




Goldberg AL, Kershah SM. Advances in Imaging of Vertebral and Spinal Cord Injury. The Journal of Spinal Cord Medicine. 2010;33(2):105-116. PMID: 20486529


Parizel PM, van der Zijden T, Gaudino S, et al. Trauma of the spine and spinal cord: imaging strategies. European Spine Journal. 2010;19(Suppl 1):8-17. doi:10.1007/s00586-009-1123-5.


Ellingson BM, Salamon N, Holly LT. Imaging Techniques in Spinal Cord Injury. World neurosurgery. 2014;82(6):1351-1358. doi:10.1016/j.wneu.2012.12.004.

sports medicine diagnostic imaging

Diagnostic Imaging in The AMA’s Guides to the Evaluation of Permanent Impairment

Diagnostic Imaging in The AMA's Guides to the Evaluation of Permanent Impairment


If you had to pick one book to be the authority on assessing personal damage in U.S. tort-civil law, you might choose The American Medical Association's Guides to the Evaluation of Permanent Impairment (AMA Guides). Personal injury law is more complicated than a single book could encompass, of course, but to this day, many U.S. courts rely on the systems set forth in the AMA Guides to determine a "quantitative estimate of function losses" within a victim's life. Many states use the AMA Guides to settle questions of workers' compensation and disability claims.


The AMA Guides assessment can also be a powerful tool in a personal injury case.


Note that the types of losses evaluated in the Guides may lead to pecuniary and/or non-pecuniary damages. In the former category, the Guides systems might uncover a loss of earning capacity or, in cases of disability, the necessity of long-term care. The AMA's Guides to the Evaluation of Permanent Impairment may also play into a claim of quality-of-life loss or limited ability due to the injury, both non-pecuniary damages.  


As we've mentioned in previous posts, diagnostic imaging can also occupy a major role in personal injury cases. So the question is: How do The AMA's Guides to the Evaluation of Permanent Impairment implement diagnostic imaging as a factor in their determination systems? And which modalities most clearly demonstrate injury, according to the Guides?


Here are a few key facts about the intersection of diagnostic imaging and The AMA's Guides to the Evaluation of Permanent Impairment that every personal injury attorney should know:



  • Diagnostic Imaging Studies are an Important Part of Injury Assessment in the AMA Guides to the Evaluation of Permanent Impairment



In assessing impairment or disability, as in health care itself, diagnostic imaging plays an outsized role. The AMA Guides present each body system in its own chapter, introducing principles of assessment for each system. In nearly every chapter, some form of diagnostic imaging appears in the Guides' assessment criteria.


The results of all diagnostic studies — including imaging — must also be part of the physician's report, according to the Guides.  



  • Imaging Modalities May Differ from One Edition to the Next



Editions matter. Depending which state you're in, the worker's compensation code may defer to the 6th and latest edition of the AMA Guides — or it might not. Some states use the 5th or even earlier editions, while others prefer state-specific criteria for evaluating injury, unrelated to the Guides. And while these codes relate specifically to worker's compensation rather than personal injury cases, the court's familiarity with a particular edition could add up to more compelling evidence of preventable injury and lasting impairment.  


Differences between editions complicate the evaluating physician's choice of imaging modality. For instance, according to analysis from health care news site Medscape, methodology changes between the 5th and 6th editions of the Guides upend the rules for assessing impairment in a knee joint injury.


"No provision was made for ratings based on magnetic resonance imaging (MRI) or arthroscopic findings of cartilage pathology in the 5th edition of the Guides," reports Medscape. "However, in the 6th edition of the Guides, there is provision for full-thickness articular cartilage defects, with a range of 5 to 9 percent impairment...MRI and arthroscopy are objective measures with accepted grading systems for cartilage lesions."


So should an attorney ask the evaluating physician for an X-ray or an MRI scan in a knee-injury case? It may depend on which court tries the case.



  • Imaging Findings Alone are Not Enough



The 5th Edition of the AMA Guides makes the important point that the results of an imaging study alone aren't enough to classify an injury as impairment or disability.


The purpose of an assessment using AMA Guides systems is to establish a diagnosis-related estimate, or DRE. DRE categories are a measure of the "impairment of the whole person," expressed as a percentage range, with 0 percent impairment equating to no injury and 100 percent representing imminent mortality.


"To be of diagnostic value, clinical symptoms and signs must agree with the imaging findings," the 5th edition AMA Guides claim. "In other words, an imaging test is useful to confirm a diagnosis, but an imaging result alone is insufficient to qualify for a DRE category."


So where does all of this leave personal injury attorneys considering the inclusion of diagnostic imaging into a particular case? The key is to work as closely as possible with the client's attending physician or, in some cases, a court-approved health care provider. In the medical setting, imaging is a crucial part of diagnosis, which is necessary for healing. In a court of law, radiographs and MRI scans are just as valuable — but for the very different purpose of assessing injury for a fair damage claim.


Interested attorneys can purchase a copy of The American Medical Association's Guides to the Evaluation of Permanent Impairment at the AMA webstore, here. For more information on how Precise Imaging can help personal injury firms better serve their clients, see our Attorney Resources page, or contact us at 800-558-2223 today.